Brady Pregerson, MD

: A woman in her 20s presents to the emergency department for 1 week of intermittent palpitations lasting hours each time. She feels it currently but denies being able to identify anything that triggers or worsens it and is not using any stimulants including coffee. She denies syncope, near-syncope, chest pain, SOB, fever, or other complaints.

: Vital signs are normal. The exam is normal except for a regularly-irregular pulse and heart rate. Specifically, there are no murmurs, rales, or peripheral edema.

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Our latest emergency department minute quiz from Brady Pregerson, MD, features a woman in her 20s with heart palpitations. Can you determine the correct diagnosis?

Emergency Department Minute Quiz: 20 Year Old Female w/ Palpitations

: A man in his 60’s with a history of a-fib presents to the urgent care for dizziness and malaise. He noticed on his apple watch that his pulse was slow. He denies syncope, palpitations, chest pain, SOB, fever, cough or other complaints.

: Vital signs are normal except for a pulse of 42. His exam is otherwise normal.

Atrial fibrillation with slow ventricular response

Moderate intraventricular conduction delay

ST deviation and moderate T-wave abnormality, consider lateral ischemia

Emergency Medicine 1-Minute Consult Pocketbook

Our latest emergency department minute quiz from Brady Pregerson, MD. Can you determine the correct diagnosis?

Emergency Department Minute Quiz: Malaise and Bradycardia

A female in her early 50’s with prior cardiac ablation for AV nodal reentrant tachycardia presents to the ED for 3 days of constant palpitations and chest pressure. She has had the same symptoms frequently for over 6 months and two ablations have not helped. She states that her heart rate is normally in the 120s at rest but recently has been in the 140s-150s. She denies fever, syncope, leg pain or swelling or other complaints.

: Vital signs are normal except for a pulse of 155. Exam is otherwise normal.

Atrial Flutter with rapid ventricular response

Our latest Emergency Department Minute Quiz from Brady Pregerson, MD. Can you determine the correct diagnosis?

Emergency Department Minute Quiz: Palpitations and Chest Pressure

: A man in his 70’s w/ ESRD on peritoneal dialysis, type 2 diabetes, and diastolic heart failure presented to the emergency department for a 2-day history of dyspnea worse than his baseline dyspnea that started yesterday around 4 pm. He takes torsemide for CHF and denies any missed doses. His baseline is dyspnea after walking for 5 minutes, but today and yesterday he felt dyspneic walking between rooms at home. He endorses some mild abdominal distension, but denies any abdominal pain, fever, chills, new leg swelling, chest pain, or other complaints.

Vital signs are normal except for a pulse ox of 92% on room air

LUNGS: labored respirations. Bibasilar rales. No wheezing.

HEART: Normal rate. Regular. Normal heart sounds.

ABDOMEN: Soft, non-tender. No guarding. No rebound. 

T-wave abnormality, consider lateral ischemia

Author | Brady Pregerson, MD

Articles

Emergency Department Minute Quiz: 20 Year Old Female w/ Palpitations

Emergency Department Minute Quiz: Malaise and Bradycardia

Emergency Department Minute Quiz: Palpitations and Chest Pressure

Emergency Department Minute Quiz: Chest Pain in CAPD Patient